PSY 183 Midterm Study Guide PDF

1 PSY 183 Midterm Exam Fair-Game Sheet History and Basic Concepts ➔ Ways of defining psychopathology (e.g., “four D’s”). ◆ Deviance: Unusual or statistically rare behavior. ◆ Distress: Emotional pain or suffering. ◆ Dysfunction: Interference with daily functioning. ◆ D...

1 PSY 183 Midterm Exam Fair-Game Sheet History and Basic Concepts ➔ Ways of defining psychopathology (e.g., “four D’s”). ◆ Deviance: Unusual or statistically rare behavior. ◆ Distress: Emotional pain or suffering. ◆ Dysfunction: Interference with daily functioning. ◆ Danger: Potential harm to self or others. ➔ Characteristics of “eccentrics” and whether they have mental disorders. ◆ Eccentrics display unique behaviors without distress, dysfunction, or danger. ◆ Not typically classified as having mental disorders. ➔ Trephination ◆ Ancient practice of drilling holes in the skull to release evil spirits. ◆ People who acted strangely were thought to have demons inside them, so holes were drilled to free them ➔ Humoral theory ◆ Ancient Greek concept of balancing bodily fluids (humors: blood, phlegm, black bile, yellow bile) to maintain mental health. Sanguine: Blood ○ Liver; Excess of blood, happy Choleric: Yellow bile ○ Gallbladder; trigger happy and easily provoked to anger Melancholic: Black bile ○ Spleen; depressed, sad Phlegmatic: Phlegm ○ Lungs; non-reactive ➔ Asylums ◆ Institutions created in the Middle Ages for those with mental disorders, often overcrowded and inhumane. ➔ Demonological view ◆ Belief that mental illness was caused by possession by evil spirits or demons. ➔ Moral treatment ◆ 19th-century approach advocating humane and respectful treatment of patients (e.g., Philippe Pinel, Dorothea Dix). ◆ Moral treatment helped people get better; eat food, take walks, etc. ➔ Types of treatments for mental disorders in early 20th century ◆ Electroconvulsive therapy, insulin coma therapy, and lobotomies.  2 ➔ Somatogenic view ◆ Theory that mental disorders have physical or biological origins. ➔ Krafft-Ebing’s discovery and Wagner-Jauregg’s treatment for “general paresis” ◆ Krafft-Ebing: Linked syphilis to general paresis (neuropsychiatric disorder). ◆ Wagner-Jauregg: Treated general paresis with induced malaria to kill the syphilis bacteria ➔ Psychogenic views of mental disorders ◆ Theory that mental disorders arise from psychological factors rather than physical ones. ➔ Hysteria ◆ Historically, a condition often associated with extreme emotional instability, attributed to psychological or “female” causes. ➔ Mesmerism/hypnotism ◆ Early methods used by Franz Mesmer, influencing modern hypnosis to treat psychological issues. ◆ Franz Mesmer was a physician who developed a method called "mesmerism," which involved using magnets and other techniques to induce a trance-like state in patients. This influenced modern hypnosis and is considered a precursor to modern psychodynamic therapy. ➔ Psychodynamic therapies ◆ Approach developed by Freud, focusing on unconscious drives and past experiences affecting current behavior. ➔ Biological views of mental disorders ◆ Mental disorders viewed as arising from genetic, neurochemical, or physiological factors. ➔ Psychotropic medications ◆ Drugs developed to treat mental disorders, including antidepressants, antipsychotics, and anxiolytics. ➔ Deinstitutionalization: rationale and outcome ◆ Rationale: Shift to community-based care for humane treatment and cost savings. ◆ Outcome: Led to a rise in homelessness and insufficient care for some individuals.  3 ➔ Rationale for multicultural psychology ◆ Recognizes diverse cultural influences on mental health and seeks culturally competent care. ◆ Multicultural psychology recognizes that culture influences mental health. It aims to provide sensitive and culturally competent care, addressing biases and promoting equity in mental health services. ➔ Types of professions in mental health ◆ Involved in direct patient care: Psychiatrists (M.D.’s) Clinical Psychologists (Ph.D.’s) Social Workers (M.S.W.’s / D.S.W.’s) Psychiatric Nurses (R.N.’s) Marriage & Family Therapists (M.F.T.’s) Psych Technicians MH Intake Workers, Staff Primary Care Practitioner M.D.’s (PCP’s) Physician Assistants (P.A.’s) Nurse Practitioners (N.P.’s) ◆ Mental health researchers: Psychiatrists Clinical psychologists Neuroscientists Endocrinologists Psychopharmacologists Geneticists Epidemiologists Clinical trial managers Biostatisticians ➔ Possible contributors to recent decline in young people’s mental health ◆ Social media use: Promotes social comparison, lowering self-esteem, especially in young females. ◆ Climate anxiety: Repeated warnings about environmental crises increase stress. ◆ Helicopter parenting: Limits resilience by protecting kids from failure or disappointment. ◆ Education without competition: Reduces preparedness for college and real-world challenges. ◆ Pressure to attend college: Family and personal expectations push some students away from alternative paths.  4 ◆ Over-pathologizing normal feelings: Everyday emotions like boredom or loneliness are labeled as disorders. ◆ Decreased stigma: Social media influencers openly discuss diagnoses, making mental health labels more common. ➔ Managed care (and Canvas reading Psychotherapy and the Pursuit of Happiness, also listed below) ◆ Insurance-based model focusing on cost-efficient, brief treatments. Critics argue it can limit quality of mental health care. Research Methods in Psychopathology ➔ Advantages/disadvantages of: ◆ (a) clinical case studies (case histories) Advantages: Detailed, in-depth insights; useful for rare cases. Disadvantages: Limited generalizability; potential researcher bias. ◆ (b) correlational methods Advantages: Identifies relationships between variables; useful in large populations. Disadvantages: Cannot determine causation. ◆ (c) experimental methods. Advantages: Can establish causation; controlled conditions. Disadvantages: May lack real-world applicability. ➔ Liabilities of correlation in clinical studies. ◆ Correlation does not imply causation; third variables may affect relationships. ➔ Problems with current research practices (WEIRD participants, biases, conflicts of interest, replication issues) Correlational studies: epidemiological (cross-sectional) vs. longitudinal (developmental) ◆ WEIRD participants: Bias due to Western, Educated, Industrialized, Rich, Democratic samples. ◆ Biases and Conflicts of Interest: Financial or personal biases may affect outcomes. ◆ Replication Issues: Difficulty reproducing findings across studies. ➔ Experimental studies: experimental /control groups; participant assignment; blind (masked) designs and experimenter bias; naturalistic, analogue, and single-subject experiments.  5 ◆ ➔ Epidemiological studies: how information is obtained; prevalence / incidence. ◆ Data Collection: Surveys, medical records, or registries. ◆ Prevalence vs. Incidence: Prevalence is total cases; incidence is new cases in a time period. ➔ IRB’s, basic rights of research participants, and problems with “informed consent” ◆ IRB (Institutional Review Board): Ensures ethical research practices. ◆ Basic Rights: Privacy, protection from harm, right to withdraw. ◆ Informed Consent Issues: Complexity and understanding by participants can be problematic. Assessment and Diagnosis ➔ DSM-5-TR conception of “mental disorder.” ◆ A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual; and that is associated with: Present distress ○ Like a painful symptom Disability ○ Impairment in one or more important areas of function With a significantly increased risk of suffering death, pain, disability, or an important loss of freedom ➔ Philosophical viewpoints and their relevance for different conceptions of mental disorder. ◆ Monism (the world is made of one stuff) Can be either all mental or all physical Most common form is “reductive materialism” ○ Mental events reduced to brain events ○ Everything is understandable as the result of physiological mechanisms ◆ Dualism (the physical and mental worlds are separate domains) Mind is different from brain World of mental and physical interact ◆ Most psychiatrists doing psychopharmacology act as monists; most psychotherapists act as dualists ➔ Kraepelin’s view on mental disorder nosology and his card-sorting method ◆ Emphasized categorizing disorders based on symptoms and course; used sorting to group similar cases. Etiology = Cause  6 ○ Etiology is family health issues, personal history, substance abuse, etc; risk factors that increase odds for disorder Course = Trajectory ○ Disorder over time Prognosis = Outcome Signs = Observable markers ○ Things you see in a patient (ticks, tone of voice) Symptoms = Patient reports ○ What the patient tells you Signs + Symptoms = Syndrome Syndrome + Course = Disorder Disorder + Tissue Damage = Disease ➔ Relationship between nosology and diagnosis ◆ Nosology: Science or scheme of disease categorization and classification ◆ Diagnosis: Act of assigning a nosological category to a patient A person can have more than one diagnosis ➔ Phenotypic vs. genotypic diagnosis. ◆ Phenotypic: Based on observable symptoms Signs, symptoms, course, outcome, response to treatment ◆ Genotypic: Based on genetic markers. Causes (Genes, germs, tissue abnormalities) ➔ Endophenotypic signs in diagnosis. ◆ Endophenotypic = markers that may indicate genotypic disorder Lab tests ○ Retinal scans for Alzheimer’s-type dementia ○ Cognitive tests ○ Tests of circadian rhythm instabilities (BPD) “Subclinical” biomarkers Behavioral tests ➔ Advantages and disadvantages of psychodiagnosis. ◆ Advantages: Guides treatment, facilitates communication among professionals, establishes prospects for contagion or transmission, legal reasons, financial reasons (insurance payment), research ◆ Disadvantages: Risk of stigma, over-pathologizing, sacrifices uniqueness of individual, diagnosis itself can have an impact on patient, and can rigidify treatment ➔ Kinds of information that go into a psychodiagnosis. ◆ Symptoms, signs, course of illness, age of onset, family history, recent events, recent behavior, psychological tests, laboratory tests (e.g. neuroimaging, hormonal assays, genetic testing), response to treatment (prior or current) ➔ Clinical interview: kinds of information solicited or observed (signs and symptoms) ◆ Signs (observable behaviors), symptoms (reported experiences). Duration: About 1 hour; crucial for diagnosis.  7 Information Collected: Current/past symptoms, personal and family history, mental health treatments. ○ Appearance: Attire, grooming, physical traits (e.g., skin tone, weight). ○ Behavior: Posture, mannerisms, spasms/tics. ○ Speech: Articulation, tone. ○ Consciousness: Alertness level. ○ Mood/Attitude: Emotional state, general attitude (e.g., defiant, sincere). ○ Thought Patterns: Content, process (delusions, hallucinations). ○ Knowledge and Thinking: General facts, abstract reasoning. ○ Social Judgment & Insight ○ Cognitive Functioning: Screened via tools like the MOCA. Goals: Assess suitability for psychotherapy, identify need for referrals (psychiatrist, PCP, neurologist, etc.). ➔ Basic diagnostic concepts: ◆ Nosology: Classification system. ◆ Diagnosis: Identifying a specific disorder. ◆ Signs & Symptoms: Observable indicators and reported experiences. ◆ Syndromes: Group of symptoms typical of a disorder. ◆ Prognosis: Predicted outcome. ◆ Course of Illness: Pattern over time. ◆ Etiology: Cause or origin. ◆ Co-Morbidity: Co-occurrence of multiple disorders. ◆ Cognitive tasks commonly used in the clinical interview including how Montreal Cognitive Assessment is used (you do not need to remember items on MOCA test): Assess attention, memory, language; Montreal Cognitive Assessment (MOCA): Checks cognitive impairment. ➔ Clinical tests: Nature of projective tests vs. personality/response inventories. ◆ Projective Tests: Interpret responses to ambiguous stimuli (e.g., TAT, Rorschach). ◆ Personality/Response Inventories: Structured self-reports (e.g., MMPI-2). ➔ Reliability / validity of diagnosis or assessment. ◆ Reliability: Consistency of results ◆ Validity: Accuracy in measuring intended constructs. ➔ Overview of TAT and Rorschach administration, interpretation, and value. ◆ TAT: Storytelling from images, reveals underlying thoughts. ◆ Rorschach: Inkblot interpretation, explores personality. ➔ General makeup of MMPI-2 (not specific scales). ◆ Broad measure of personality traits, designed to identify mental health issues. ➔ Psychophysiological tests & polygraphy. ◆ Measures physical responses (e.g., heart rate) linked to mental states; polygraph assesses stress responses.  8 ➔ Major types of brain imaging. ◆ CT, MRI: Structural images ◆ fMRI, PET: Functional activity. ➔ IQ testing and use of IQ. ◆ Measures cognitive ability, often used in neuropsychological assessments. ➔ Neuropsychological tests. ◆ Evaluate cognitive functions to identify brain impairments. ➔ History, development and construction of DSM-5-TR – general principles and organization. Dimensional and ancillary information in DSM-5-TR ◆ DSM-5-TR History and Organization: Developed over time, structured by symptom clusters and functional impact. ◆ Dimensional and Ancillary Information in DSM-5-TR: Includes symptom severity, cultural context, and functional impact. ➔ Evidence-based treatment guidelines. ◆ Recommendations based on research for effective treatments. ➔ Psychotherapy: general effectiveness and meta-analysis. ◆ Shows general efficacy; meta-analyses summarize broad therapy effects. ➔ Common factors in effective psychotherapy, and the “rapprochement movement.” ◆ Includes therapeutic alliance, empathy, and rapport; rapprochement integrates various therapy approaches. ➔ Pharmacogenomics. ◆ Tailoring medication based on genetic factors. ➔ Co-morbidity. ◆ Co-existence of multiple disorders in one person, complicates diagnosis and treatment. Major Depression ➔ Cognitive/motivational vs. neurovegetative signs/symptoms of Major (Unipolar) Depression, and cultural specificity. ◆ Cognitive: Sadness, guilt, feelings of worthlessness, suicidal thoughts. ◆ Motivational: Loss of pleasure (anhedonia). ◆ Neurovegetative: Weight changes (appetite changes) Sleep issues (insomnia or excessive sleep) Psychomotor changes (agitation or slowed movement) Fatigue, difficulty concentrating. ◆ Not Due To: Bereavement, normal loss reactions, or substances.  9 ◆ Resulting Behavior: Social withdrawal, isolation, and possible irritability (especially in teens and males). ➔ Psychodynamic account of Major Depression w/ problems. ◆ Cause: Unconscious conflicts from early losses or unmet needs. ◆ Mechanisms: Repressed anger turned inward, unresolved grief, dependency needs. ◆ Problems: Empirical Limitations: Unconscious processes are hard to measure. Childhood Focus: May ignore current stressors or biology. ◆ Treatment Issues: Insight therapy isn’t effective for everyone. ➔ Post-partum depression vs. “baby blues,” incl. possible etiologies of post-partum depression. ◆ Baby Blues: Common, affecting 50-80% of new mothers. Symptoms: Mild mood swings, irritability, sadness, anxiety. Duration: Typically resolves within two weeks postpartum. ◆ Postpartum Depression: Affects about 10-20% of mothers. Symptoms: More intense and lasting sadness, hopelessness, fatigue, possible suicidal thoughts, impaired bonding with the baby. Duration: Persists for weeks to months if untreated. Etiologies: Hormonal changes, previous depression history, stress, lack of support, potential genetic factors. ➔ Patterns of Major Depression occurrence (episodes, persistence, recurrence, etc.) ◆ Patterns of Major Depression Occurrence: Episodes: Symptoms lasting at least two weeks, but can extend for months. Persistence: In some, depression symptoms remain chronic or long-lasting. Recurrence: High risk of future depressive episodes after one occurrence, especially if untreated, with around 50% experiencing recurrence within five years. ➔ Sex ratios in prevalence of Major Depression, possible explanations, and implication of Amish findings. Genetic evidence on prevalence of depression. ◆ Females are diagnosed more often than men (2:1 ratio) ◆ Male depression is often masked by alcohol and drug abuse ◆ Explanations offered to explain the 2:1 ratio: X-linked depression genes PMS symptoms concurrent with house to house surveys (MDD) Quality of life for females vs males  10 Female masochism (Freud) Cognitive style ○ Females dwell on problems more than males ○ Men avoid or try to escape their problems ➔ “Kindling” and depression risk. ◆ History of previous depressive episodes serves as kindling ➔ Persistent depressive disorder and “double depression.” ◆ The overlay of a Major Depressive Disorder episode on top of the persistent depressive disorder Person gets into an even deeper depressive episode when they usually already struggle with a “baseline” depression ➔ Psychotic features in severe Major Depression, e.g., hallucinations and delusions. ◆ Severe depression may include hallucinations (e.g., hearing voices) and delusions (e.g., beliefs of guilt or worthlessness). ➔ Types of psychotherapy for Major Depression – rationales, evidence for effectiveness. ◆ Cognitive Behavioral Therapy (CBT): Targets negative thought patterns; proven effective. ◆ Interpersonal Therapy (IPT): Focuses on relationship issues; evidence supports effectiveness. ◆ Behavioral Activation: Increases engagement in positive activities; effective in lifting mood. ➔ Natural remission of Major Depressions and relevance for theories of depression. ◆ Some depressive episodes resolve on their own, suggesting natural cycles; informs theories of depression’s episodic nature. ➔ Problems with psychogenic theories of the causation and treatment of Major Depression. ◆ Overemphasis on psychological origins may overlook biological causes and limit treatment options. ➔ ACT and MBCT: “third-wave” variants of Cognitive Behavior Therapy. ◆ ACT (Acceptance and Commitment Therapy): Encourages acceptance of thoughts. ◆ MBCT (Mindfulness-Based Cognitive Therapy): Uses mindfulness to prevent relapse; both have evidence for effectiveness. ➔ Brain changes (including BDNF, neocortical and neurotransmitter disturbances) in depression, and possible mechanisms of action of major classes of antidepressant drugs. ◆ Changes include low BDNF, neurotransmitter imbalances, and neocortical disturbances; antidepressants may normalize these. ➔ Types of antidepressant medications: uses in depression and other disorders, side effects, precautions, and general drug classes (you will not need to recall any specific drug names) ◆ Classes: SSRIs, SNRIs, MAOIs, tricyclics; used for depression, anxiety, and  11 OCD. ◆ Side Effects: Vary by class; can include fatigue, nausea, and dry mouth. ◆ Precautions: Care with dosage; side effects may impact treatment adherence. ➔ Relationship between antidepressant medication and suicidality, and period of suicide risk in treatment. ◆ Initial treatment phase may raise suicide risk; close monitoring is essential. ◆ Patient is at highest risk for suicide when they start feeling better and never want to go back to such a dark place, or finally having the motivation to kill themselves ➔ ECT -- nature of treatment, effectiveness, and side effects. ◆ Treatment: Uses controlled electrical impulses to induce seizures. ◆ Effectiveness: High for severe depression; side effects may include memory loss. ➔ Nature and effectiveness of alternative treatments: TMS (including “Stanford protocol”), VNS, and ketamine treatment (also see Text Addenda below). ◆ TMS (Transcranial Magnetic Stimulation): Stimulates brain regions; “Stanford protocol” has promising results. ◆ VNS (Vagus Nerve Stimulation): Uses a device to stimulate the vagus nerve. ◆ Ketamine: Rapid relief for severe cases; used under careful supervision. ➔ Comparative effectiveness of medications vs. psychotherapy for different degrees of Major Depression. ◆ For mild to moderate depression, both can be effective; severe cases may benefit more from medication. ➔ Overview of SADS and phototherapy. ◆ SAD: Depression occurring seasonally. ◆ Phototherapy: Light therapy to improve mood; effective in many cases. ➔ Other disorders that are associated with depression and frequently treated with antidepressant medications. ◆ Anxiety disorders, OCD, PTSD, chronic pain Mania and Bipolar Disorder ➔ Hypotheses about etiology, including neurochemistry. ◆ Etiology Hypotheses: Neurochemical imbalances (e.g., high dopamine or norepinephrine in mania). Structural brain changes and dysfunction in emotional regulation  12 circuits. ➔ Genetic evidence, sex ratio in prevalence. ◆ Strong genetic component; close family history increases risk. ◆ Equal prevalence in men and women, though women may have more depressive episodes. ➔ Signs/symptoms. ◆ Manic Episode: Elevated mood, decreased need for sleep, rapid speech, impulsivity, grandiosity. ◆ Depressive Episode: Symptoms similar to Major Depression but with higher recurrence and intensity in Bipolar Disorder. ➔ Course and prognosis. ◆ Chronic condition with recurrent episodes; variable between individuals. ◆ Higher risk of suicide; lifelong management often required. ➔ Differences between Major Depression and Bipolar depression. ◆ Bipolar depression includes manic or hypomanic episodes; depressive episodes may be more severe than in Major Depression. ➔ Types of antimanic medications (mood stabilizers): side effects, precautions, and general classes of medications (you will not need to recall any specific drug names). ◆ Classes: Lithium, anticonvulsants, atypical antipsychotics. ◆ Side Effects: Weight gain, tremor, kidney or thyroid effects; requires regular monitoring. ➔ Pharmacogenomics and the use of the Genesight© Test. ◆ Personalized treatment approach using genetic testing to guide medication choices. ➔ Non-medication treatments. ◆ Psychotherapy (CBT, psychoeducation), lifestyle modifications, ECT for severe cases. ➔ General features of pediatric bipolar disorder. ◆ Similar symptoms to adult Bipolar Disorder but with more irritability, mood swings, and behavior issues. ➔ Relationship of bipolar disorder and/or depression to creativity ◆ Higher rates of creativity observed in some individuals with bipolar or depressive tendencies. ➔ Other disorders associated with bipolar disorder. ◆ Anxiety disorders, substance abuse, ADHD, personality disorders. Suicide (Text Readings Only) ➔ Rates of males vs. females in attempted vs. completed suicides and explanation ◆ Three times as many women attempt suicide as men, yet men due from their attempts at more than three times the rate of women  13 ◆ Men tend to use violent methods (shooting, stabbing, or hanging themselves) whereas women use less violent methods (drug overdose) ➔ Likeliest people to die by suicide in U.S. ◆ Non-Hispanic white Americans more than twice as high as that of African Americans, Hispanic Americans, and Asian Americans ◆ American Indians also have a very high suicide rate May be explained by extreme poverty of many American Indians ➔ Likely reasons for recent increase in deaths by suicide. ◆ Social media and internet use ➔ Leading risk factors for suicide. ◆ Stressful events Social isolation Serious illness Abusive or repressive environment Occupational stress ◆ Mood and thought changes Hopelessness Dichotomous thinking (all or nothing) ◆ Alcohol and other drug use ◆ Mental disorders ◆ Modeling More people attempt suicide after observing or reading about someone else who has done so ➔ Protective factors in suicide. ◆ Social Support: Strong family and community connections. ◆ Access to Care: Availability of mental health resources. ◆ Coping Skills: Effective problem-solving abilities. ◆ Beliefs and Values: Religious or spiritual commitment. ◆ Dependents: Responsibility toward loved ones or pets. ◆ Future Orientation: Optimism and plans for the future. ◆ Therapeutic Relationship: Positive bonds with mental health professionals. ➔ Basic interventions to prevent suicide and treat high-risk people. ◆ Suicide Prevention Program: Program that tries to identify people who are at risk of killing themselves and to offer them crisis intervention ◆ Crisis Intervention: Help people see their situation more accurately, make better decisions, act more constructively, and overcome crisis ➔ General evidence for “contagiousness” of suicide. ◆ Media Influence: High-profile suicide reports can lead to copycat suicides, especially when details are sensationalized. ◆ Social Influence: Suicide clusters can occur in close-knit communities or groups, often due to shared exposure or social connections. ◆ Social Media Impact: Online platforms can amplify suicide-related content, increasing exposure to at-risk individuals. ◆ Family/Friend Influence: Individuals with loved ones who die by suicide  14 have higher risks, especially when exposed at a young age. Anxiety Disorders ➔ Nature of clinical “anxiety”: signs and symptoms. ◆ Signs/Symptoms: Persistent worry, restlessness, muscle tension, difficulty concentrating, sleep issues. ➔ Sociocultural characteristics that affect anxiety. ◆ Cultural attitudes, socioeconomic stress, social expectations influence anxiety severity and expression. ➔ Brain areas, neurotransmitters and ANS involvement in anxiety. ◆ Brain Areas: Amygdala, prefrontal cortex. ◆ Neurotransmitters: GABA, serotonin. ◆ ANS Involvement: Fight-or-flight response, increased heart rate, sweating. ➔ Physical conditions that can masquerade as anxiety disorders. ◆ Hyperthyroidism, heart arrhythmias, asthma, and other medical issues. ➔ Types of symptomatic treatments for anxiety, including classes of anxiolytic medications: differences, precautions, side effects, and general classes of drugs. ◆ Medications: Benzodiazepines, SSRIs, SNRIs. ◆ Caution: Risk of dependence (benzodiazepines); side effects include drowsiness, nausea. ➔ Know major etiological aspects and diagnostic features of, and treatments for: ◆ Generalized Anxiety Disorder (GAD): Persistent, excessive worry across multiple areas of life; treatment includes CBT, SSRIs. ◆ Panic Disorder: Intense fear episodes with physical symptoms; heightened interoception and “anxiety sensitivity.” ◆ Derealization/Depersonalization: Feelings of detachment from reality or self; often treated with grounding techniques and therapy. ◆ Agoraphobia: Fear of situations where escape might be difficult; associated with panic attacks. ◆ Social Anxiety Disorder: Intense fear of social situations due to fear of scrutiny; treated with CBT, exposure therapy. ◆ Specific Phobias: Excessive, irrational fears of specific objects/situations; behavioral  15 etiology suggests learned associations and “preparedness” (evolutionary predisposition). ➔ Obsessive-compulsive Disorder: ◆ Features: Obsessions (intrusive thoughts) and compulsions (repetitive behaviors); chronic but treatable. ◆ Risk Factors: Family history, trauma, brain structure abnormalities. ◆ Brain Areas in OCD: Orbitofrontal cortex, anterior cingulate cortex, striatum. ◆ OCD-Related Disorders: Hoarding Disorder: Difficulty discarding items. Body-Focused Repetitive Behaviors: E.g., hair-pulling (trichotillomania), skin-picking (excoriation). Body Dysmorphic Disorder: Preoccupation with perceived body flaws. Body Integrity Dysphoria: Desire for amputation of a healthy limb. “Unofficial members”: Tourette’s, “Homosexual OCD,” Erotomanic Delusional Disorder. ◆ PANDAS Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections, often linked to OCD symptoms. ◆ Why hypochondriasis (DSM-5-TR Illness Anxiety Disorder) is often considered an OCD-Spectrum Disorder. Similar to OCD spectrum; characterized by excessive worry over health and potential illness. From Canvas Assigned Readings and Text Addenda: ➔ Student Mental Health Is in Crisis: Nature of stressors on college students and consequences. ➔ Psychotherapy and the Pursuit of Happiness (Canvas): National Mental Health Act; emergence of clinical psychology; rise of short-term psychotherapy and community psychology; evolution of “caring” ethos; evolution of managed care. ➔ Mental Disorders: Infectious Diseases? (Text pp. 4-1 – 4-12): Problems w/ neurotransmitter account of antidepressant medication action, malarial cure of neurosyphilis, evidence suggesting possible infectious etiologies for OCD,  16 ➔ Major Depression and Schizophrenia. ➔ Ketamine and Other Medication Treatments for Depression (Text pp. 8-1 – 8-6): Procedure and evidence on ketamine therapy; potential advantages of ketamine treatment for Major Depression; TRD and general alternatives for TRD management; combinatorial genomics and purpose of GeneSight© test. ➔ Body Integrity Identity Disorder (Text pp. 5-1 – 5-5): parallels w/transgenderism, etiology, signs/symptoms, course, treatment, controversy. ➔ Clinical Focus: Tourette Syndrome (Text p. 5-6) – relationship to OCD